[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6632479,"mediaKeyId","2675129-bdaf028a57d7c6e67e2dcba566e8c998","parentId",2675129,"title","Assembly members press DHCS to convene Prop 35 advisory panel as providers await rate increases","audioSeconds",842,"startMs",7700000,"endMs",8542000,"viewUrl","/Search/View?dp=1&key=2675129-bdaf028a57d7c6e67e2dcba566e8c998&start=7700&end=8542","thumbnailUrl","https://assets.pipeline.soar.com/2675129-bdaf028a57d7c6e67e2dcba566e8c998/thumbnail_7700000.jpg","articleUrl","/articles/6632479/California/Assembly-members-press-DHCS-to-convene-Prop-35-advisory-panel-as-providers-await-rate-increases","mediaUrl","https://secure.pipeline.soar.com/6632479-3eca2c4b29387c931046ca8ebca0b4da/orig.mp4?Expires=1775042184&Signature=OLFAL2P7nU0-OL5Dk0f63rw3YML1sttaSWvXdCBAa5p7BzWZcXm3OHRwRQnsNS4AZi8vRuoSTJ6QIak4cJy2aewLye-Bfhairgtb6-KWVuWrKoq6EcRFqpmCQCZFUsYh9xeBKU5ncOPSt2P~s3oCUBN1FczhUGC8-vYjHavRT3KIo5FheX4E4VIhFidRBXhEHOlnt7pb6qDBPc7hvTdBChcWxAtT4VyMVzHEospkb~MJOpOXWQOg94fHoK6mDLUOEz41mHi1U3hLrlpS9HbOMmLldbtVWl~sFXlsm2EswIu-VNrz8squE71wi9PgQyAkBUHmVSdR5LJ~8LiBijYR-w__&Key-Pair-Id=KUT5TJCACFTXG","author","California State Assembly","date","2025-03-17T00:00:00Z","article","Lawmakers and providers urged the Department of Health Care Services to convene the Proposition 35 stakeholder advisory committee and begin implementing the managed‑care‑organization (MCO) tax spending plan to speed provider rate increases and draw down federal matching dollars.

DHCS staff said the committee requires a six‑member quorum and that legislative appointees were recently completed; the department is preparing committee meeting materials and timelines. Jason Constantura of DOF and DHCS emphasized that the administration’s initial spending plan is reasonable but incomplete; the Legislative Analyst’s Office recommended early legislative oversight because federal rule changes could shrink future MCO tax capacity and because Proposition 35 changes how funds must be allocated beginning in 2027.

Providers urged speed. George Soares of the California Medical Association, Mark Farouk of the California Hospital Association and other provider groups told the subcommittee that delays could forfeit hundreds of millions in federal matching funds and leave clinicians and hospitals waiting years for rate increases that are already authorized in last year’s budget act. ‘‘Rate increases often take a long time to reach physicians,’’ the California Medical Association said in public comment, noting some plans had not implemented 2023–24 rate increases.

Rural and emergency services: Air ambulance operators and emergency medical air services requested interim (bridge) funding for 2025–26, warning of base closures without a short‑term payment pathway. Air ambulance witnesses said roughly 40% of their transports involve Medi‑Cal patients. Other providers — pediatric dental, audiology, prosthetics and hospitals — requested that particular buckets in the Prop 35 investment plan be implemented quickly and transparently.

Congregate living health facilities: Several speakers from congregate living health facilities (CLIFs) described losing expected rate increases and asked the Legislature to restore modest funding that was rendered inoperative by the passage of Proposition 35. CLIF owners and residents described the facilities as lower‑cost, community‑based alternatives to institutional care for people with catastrophic injuries.

Why it matters: Proposition 35 appropriated MCO tax revenues for provider investments and specified domains for investment; implementing the spending plan affects which providers receive immediate increases and how much general fund offset is available for Medi‑Cal operations. Federal rule changes and Proposition 35’s 2027 allocation rules could reduce future MCO tax flexibility, which could in turn raise general‑fund costs.

What was not decided: The subcommittee did not adopt formal instructions; DHCS said meetings will be scheduled quickly now that legislative appointments are complete and that specific payment methodologies will follow stakeholder consultation. The LAO urged the Legislature to consider questions about timing, distribution methods, and contingency planning for a possible smaller MCO tax in 2027.

Ending: Providers and patient advocates pressed legislators to ensure prompt, transparent action so that rate increases reach providers and that bridge funding addresses urgent access gaps while the Prop 35 implementation process proceeds.","mediaType","Video","parentTitle","Assembly Budget Subcommittee No. 1 on Health (1)","oneSentenceSummary","Providers and Assembly members urged DHCS to convene the Proposition 35 stakeholder advisory committee and begin implementing MCO‑tax financed rate increases, warning that delays could forfeit federal matching funds and worsen access in rural and specialty care.","taxTitle","California State Assembly, House, Legislative, California","taxId",17099,"location","California","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6632484,"Counties press DHCS on underfunded California Children's Services; debate over opioid settlement spending",466,5452000,5918000,"/Search/View?dp=1&key=2675129-bdaf028a57d7c6e67e2dcba566e8c998&start=5452&end=5918","https://assets.pipeline.soar.com/2675129-bdaf028a57d7c6e67e2dcba566e8c998/thumbnail_5452000.jpg","/articles/6632484/California/Counties-press-DHCS-on-underfunded-California-Childrens-Services-debate-over-opioid-settlement-spending","https://secure.pipeline.soar.com/6632484-8008e8566b503f83365635eb1fd531c0/orig.mp4?Expires=1775042184&Signature=B8tbwyxgp8ft7vWDOOgwRz6MLCXKZnqsjprj1GZ4M~2R20ld1k2bF5MyW6A-qYHJzIcP27bkKw4ucScFNU6UqGgcuSzvkIWOQgpdkFVu3xxXRdTfyRpJxRfqQogDH4scuFG-tiV0Wf3jp6N3hknN7~gf2h9PV5mv5IipvVc0Rd8b99h3LPYB7cKFQVQ4pQicelYs1irS3hR3Mj4zTlmZPjYieyuxrUB3cTp3m2NcCsmhBUpTUXz~TPQsVBHxkhOLq9SfKcW1jepYKp3h4EpQ9kVrykYx8D74653Gg~iIwLBTHYfgSF8zUFCapkFJzGFrtIKiOsU2g-QJOzoWsNCN9Q__&Key-Pair-Id=KUT5TJCACFTXG","County and provider representatives told the Assembly Subcommittee on Health that recent changes to California Children’s Services (CCS) budget methodology left some counties underfunded and unprepared for new monitoring obligations.

Susan Philip, deputy director for Health Care Delivery Systems at the Department of Health Care Services, described a change to county CCS allocation methodology that bases allocations on counties’ recent average expenditures and average caseload rather than prior staffing‑standard calculations. Philip said DHCS has engaged with counties through monthly meetings with the County Health Executives Association of California (CHEAC) and has delayed full implementation of the CCS monitoring and oversight (MNO) program until July 1, 2025, after issuing an MOU and associated monitoring protocols.

CHEAC and county witnesses said the new approach left core CCS budgets short. Jack Anderson of CHEAC told the committee counties estimated a statewide underfunding of roughly $115,000,000 for 2024–25 using DHCS staffing standards and urged an indefinite delay of the MNO rollout until funding sufficiency is resolved. Philip said DHCS provided $10,000,000 in 2024–25 to support readiness activities and is developing a training program and provider manual to support county implementation; six counties have signed the MOU to date.

Opioid settlement and Naloxone question: The panel also discussed opioid settlement fund (OSF) revenues and the governor’s proposal to prioritize a Naloxone Distribution Project. Elizabeth Castillo of the Department of Finance said the governor’s budget included $8,300,000 in opioid settlement funds in 2025–26 for the Naloxone Distribution Project and maintained $41.7 million in OSF in 2024–25. The administration said it reexamined the OSF expenditure plan based on updated revenue estimates and prioritized naloxone procurement and distribution as an administration priority.

Several harm reduction providers and advocates urged that OSF allocations for syringe services and community harm‑reduction programs not be reduced. Speakers from harm‑reduction programs told the committee that community programs provide outreach and distribution that reduce overdose deaths and that many county OSF allocations remain unspent. Some advocates urged returning $8,400,000 of proposed Naloxone Distribution Project funding back to the California Overdose Prevention and Harm Reduction Initiative (COHRI/COFRE) to support community programs.

What was decided: DHCS pushed back the CCS MNO implementation date from an earlier schedule to July 1, 2025, and provided $10,000,000 for county readiness. The administration said it would reassess the opioid settlement expenditure plan at the May revision based on updated revenues.

Why it matters: CCS provides specialty diagnostic, treatment and therapy services for children up to 21 with serious medical conditions. Counties and advocates said adequate funding and technical assistance are needed to avoid service gaps and to ensure monitoring improves access rather than simply increasing administrative burden. The opioid settlement discussion raises questions about how front‑loaded settlement revenue, bankruptcy settlements and local spending affect statewide harm reduction programming.

Ending: Both county officials and community providers asked the Legislature and administration to work together to reconcile funding shortfalls, pace monitoring and oversight implementation and ensure that opioid settlement resources continue to support front‑line harm‑reduction services.","County and provider witnesses told the Assembly Subcommittee No. 1 on Health that recent CCS allocation changes have left some counties underfunded and asked the department to delay or adjust the monitoring and oversight rollout until funding and technical assistance gaps are addressed.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6632488,"Assembly subcommittee hears DHCS request for loan as Medi‑Cal costs surge",1076,1356000,2432000,"/Search/View?dp=1&key=2675129-bdaf028a57d7c6e67e2dcba566e8c998&start=1356&end=2432","https://assets.pipeline.soar.com/2675129-bdaf028a57d7c6e67e2dcba566e8c998/thumbnail_1356000.jpg","/articles/6632488/California/Assembly-subcommittee-hears-DHCS-request-for-loan-as-MediCal-costs-surge","https://secure.pipeline.soar.com/6632488-49ae8a1cf4bafcb7925101121c57a8f4/orig.mp4?Expires=1775042184&Signature=HpTYsax8Z3o~aePSi4yNHBASYeb7FuH0Z1g80y44mPBlQGMb2Qfqp2jjCXBGwA0qinVWDouXEXNvno-oS0K5wg-UurfT1NGwn4Ej8YGfoIrHkBRg~rdZnCESLOV69aHKGFxXOy~jmNOIAj5G2z9v0OCelTI~GU2xyf8t45D52Ty7kk-A1z9yCP999gTBbg1nXQg3qf1UvRvaC3g3sZPqYohkSgU1wKumhTHb5-FOYnBpO~8HaVH2qnjpuwJPvJHzt0mrcMoBuZTZrhTcz~55yR1KJdcT-wIeT-zvF7mHzSEOehBwpkG0U6kFry-KR5A2iMZ2yc5VBVcm2o~s7Jrj-Q__&Key-Pair-Id=KUT5TJCACFTXG","The Assembly Subcommittee No. 1 on Health heard administration and fiscal analysts describe steps taken to maintain Medi‑Cal cash flow as program costs exceeded earlier projections.

Department of Health Care Services Director Michelle Baass told the panel that “on March 4 the Department of Finance activated a $3,440,000,000 medical provider interim payment loan to the department” to manage medical cash flow and ensure providers and plans are paid on time. Baass added the administration will seek an additional $2,800,000,000 consistent with the governor’s projected current‑year shortfall identified in the governor’s budget.

The loan and supplemental request follow upward revisions in the November 2024 Medi‑Cal estimate. DHCS said the November estimate projected $174,600,000,000 in total Medi‑Cal spending and $37,600,000,000 in state general fund for the current year; the budget year estimate rose to $188,100,000,000 total funds and $42,100,000,000 general fund due to higher caseload and spending projections.

Why it matters: Medi‑Cal covers nearly 15,000,000 Californians, about one in three residents, including 3 in 7 children and around 40% of births. A change in federal matching rules, delays in federal revenue reconciliations and faster‑than‑expected enrollment growth could force the state to alter its budget plans unless the loan and other actions preserve payment capacity.

Drivers and timing: DHCS and fiscal staff attributed higher near‑term general‑fund needs to multiple, documented factors rather than a single cause. Baass and other witnesses pointed to:
- Caseload increases tied to policy changes, including elimination of an asset test and expanded coverage to more adults, and continued effects of the post‑public‑health‑emergency “unwinding” redetermination process; DHCS said enrollment has remained near 15 million compared with a pre‑pandemic enrollment near 13.14 million.
- Higher pharmacy spending, including increased use of GLP‑1 medications and lower‑than‑expected prior‑year rebate reconciliations.
- The timing of revenue receipts such as managed‑care organization (MCO) tax collections and supplemental payments, which influence Medi‑Cal’s cash‑basis accounting and can produce large swings between fiscal years.

Ryan Miller of the Legislative Analyst’s Office urged caution in reading the numbers. “This is something that’s heard every year in the budget,” he said, adding the total is “the sum total of estimated spending for dozens of programs, hundreds of individual issues,” and that May revision numbers will be updated when more months of data are available.

Committee members pressed DHCS on when the state would have firmer numbers. Baass said work on the May revision will incorporate additional actual data through January 2025 and that more granular line‑item detail would be available at that time.

Public comment and stakeholder response: Dozens of community groups and providers testified during the hearing’s public comment periods, urging preservation of Medi‑Cal coverage and warning against cuts. Health Access California, immigrant‑advocacy groups and provider associations said expansions to eligibility had increased enrollment for reasons consistent with legislative intent and warned against politicizing the loan request.

What was not decided: The subcommittee did not take any formal vote. The loan enacted by the Department of Finance is an administrative cash‑management action; the administration announced it will seek legislative approval for additional borrowing identified in the governor’s budget process.

Next steps and context: DHCS and fiscal offices said May revision estimates will incorporate more complete data and that the administration will continue updating projections. Members said they expect to review more detailed line‑item drivers and may hold further hearings as May revision numbers are finalized.

Ending: Committee members and witnesses repeatedly stressed the fragility of timing on revenue recognition under cash‑basis accounting and the role of pharmacy costs and enrollment changes in near‑term pressure on the state general fund for Medi‑Cal. The subcommittee plans to revisit Medi‑Cal budget estimates after the May revision.","The Assembly Subcommittee on Health heard Department of Health Care Services officials explain a newly activated March cash loan and a request for additional state borrowing to address higher‑than‑expected Medi‑Cal spending driven by enrollment, pharmacy costs and timing of revenue collections.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6632474,"School districts report billing delays for CYBHI fee schedule; districts warn of layoffs without bridge funding",1067,10710000,11777000,"/Search/View?dp=1&key=2675129-bdaf028a57d7c6e67e2dcba566e8c998&start=10710&end=11777","https://assets.pipeline.soar.com/2675129-bdaf028a57d7c6e67e2dcba566e8c998/thumbnail_10710000.jpg","/articles/6632474/California/School-districts-report-billing-delays-for-CYBHI-fee-schedule-districts-warn-of-layoffs-without-bridge-funding","https://secure.pipeline.soar.com/6632474-d620d16b76c6eecdad490507341c2bd4/orig.mp4?Expires=1775042184&Signature=cex2089eX6cR2i57rM3jxsC6vGBVaR4d5R1pyEWy9gIGLNsVnrO5OIVXGKR69dJhZDMtRzsZCCrlnP~nPjguxcjR305JI4QioLtw4Opt6nIF6~YLuZDYZo5V3-RGAEW-hchH08021~0M2F~gxGvmMN-lFQ0K76uCxJt6VJq-2YKUUaoKDj4FWkOKo~KNrhjIpJLR7yrHW8SZP2c4u~MoljyG64FRVII7YU9ZYR8o3kCFOGCnxox-a0LXrAPPsDy2pRKmxVNpZGPKN5amgnt1es75rE-8U43PQe9Jqir3zl4eg~S4pucesmXcJdavtglSx2K2Gq8Fl4r7kNAmCoUYxQ__&Key-Pair-Id=KUT5TJCACFTXG","School and county education officials told the Assembly Subcommittee on Health that implementation delays for the Children and Youth Behavioral Health Initiative (CYBHI) fee schedule risk dismantling school‑based behavioral health capacity built with one‑time grants.

Tyler Sedwith, state Medicaid director at DHCS, outlined the fee schedule as a first‑of‑its‑kind reimbursement pathway for outpatient behavioral health services delivered at schools and school‑linked settings. DHCS awarded $400,000,000 in one‑time grants to local educational agencies (LEAs) as readiness funding and created four implementation cohorts. Carillon Behavioral Health serves as the program’s third‑party administrator (TPA).

But Fresno County Superintendent Trina Frazier and Los Angeles Unified School District Executive Director Joel Cisneros told the committee that the rollout has been slower than expected. Fresno said it applied to cohort 1 in October 2023 and submitted its first claim only on February 8, 2025, despite plans to claim earlier. Fresno reported hiring wellness coaches in October but said many coaches face layoff notices because wellness‑coach rates and billing pathways were not available. LAUSD said it expects to submit its first claim shortly after completing onboarding and stressed years of experience with LEA billing does not eliminate the administrative complexity of the CYBHI fee schedule.

Districts and county offices of education asked for clarity and suggested a short‑term bridge fund while DHCS and the TPA resolve operational issues and ramp claims processing. Several county offices reported that the enrollment and student insurance verification process — and both FERPA and HIPAA concerns when handling student health information — have delayed claims submission.

DHCS said it has provided one‑on‑one technical assistance, created peer learning opportunities among LEAs, and is revising program guidance; the department also said it would allow additional submission windows beyond the usual 180‑day claim period for cohort 1 participants that showed good‑faith efforts to onboard.

Why it matters: Schools often serve as the first access point for youth behavioral health; sustained reimbursement is considered essential to retain staff hired with one‑time grant dollars. Delays in billing and uncertainty about eligible provider types and rates threaten both service continuity for students and the financial viability of school‑based providers.

What was not decided: The Legislature did not adopt bridge funding at the hearing. DHCS committed to continuing technical assistance, expediting onboarding and coordinating with the TPA and plans to expand cohorts in 2025–26.

Ending: Members said they will monitor implementation closely and urged DHCS to prioritize timeliness so districts do not lose staff and students do not lose access to services they now receive at school.","Local education agencies in early implementation cohorts told the Assembly subcommittee that technical and administrative obstacles, delayed guidance and late onboarding of the third‑party administrator have limited claims submission under the Children and Youth Behavioral Health Initiative fee schedule and put staff at financial risk.","actionData","errors"]

Article not found

Assembly members press DHCS to convene Prop 35 advisory panel as providers await rate increases

Counties press DHCS on underfunded California Children's Services; debate over opioid settlement spending

Assembly subcommittee hears DHCS request for loan as Medi‑Cal costs surge

School districts report billing delays for CYBHI fee schedule; districts warn of layoffs without bridge funding